Number of Tents: Date(s) tent(s) required: to Number of Days For what will the tent be used?

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1 CITY OF NAPERVILLE DEVELOPMENT SERVICES TEAM APPLICATION FOR TENT PERMIT Permit # Complete this application and submit it to the Development Services Team (DST), 400 S. Eagle Street, Naperville. Applications will not be accepted by mail. For further information, contact the DST at (630) option 2. The application must include all of the requirements listed on the TENT PERMIT REQUIREMENT SHEET. All information must be complete. Incomplete applications will not be accepted. Please type or print clearly. Tent Address City ST Zip Applicant Address City ST Zip Phone ( ) Contact Property Owner Address City ST Zip Phone ( ) Contact Tent Contractor Address City ST Zip Phone ( ) Contact NOTE: Tents can be erected for a maximum of 14 days. If additional days are required, a Temporary Structure permit application is needed, as per Section 5-2A-2 of the Naperville Municipal Code Number of Tents: Date(s) tent(s) required: to Number of Days For what will the tent be used? ITEMS SUBMITTED: Application Disclosure of Beneficiaries Drawing/Site Plan Cert. of Insurance City Property Only Certificate of Flame Proofing Electrical Certification I,, being the applicant or owner of the premises in which the tent installation(s) shall be made, agree to conform with and abide by all the rules, regulations, and provisions of the City Ordinances pertaining to the installation and maintenance of tents now or hereafter in force. Signature Date Rev. 4/06/06H:\Department\TED\Development Services Team\Development Services Team (DST)\Front Counter-CSA\Permit App-letters\Permit Applications- Counter\TENTS\Tent Packet\(1) TentApp.doc

2 FOR OFFICE USE ONLY BUILDING APPROVAL: DATE: Proceed with tent permit issuance YES NO Additional Information Requested DPU ELECTRIC APPROVAL: DATE: Proceed with tent permit issuance YES NO TEMP ELECTRIC SERVICE: GENERATOR: YES NO YES NO Additional Information Requested PLANNING/ZONING APPROVAL: DATE: Proceed with tent permit issuance YES NO Additional Information Requested FIRE DEPARTMENT APPROVAL: DATE: Proceed with tent permit issuance YES NO Additional Information Requested SUBMIT APPLICATION AT COUNTER SEE SPECIAL EVENTS COORDINATOR ISSUE PERMIT OVER THE COUNTER SPECIAL EVENTS APPROVAL

3 TENT PERMIT REQUIREMENTS 1. Certificate of Insurance evidencing General Liability coverage (If on City owned property) with $2,000,000 combined single limit minimum must be presented and must include the City of Naperville named as additionally insured. 2. Disclosure of Beneficiary form completed and notarized. (City Clerk s Office will notarize at no charge to the applicant.) 3. Copy of certificate of flame proofing for tent(s). (See Exhibit A) 4. A drawing or site plan showing where the tent(s) will be placed on site, including the dimensions of the tent and indicating the number of parking spaces covered by the tent area (See Exhibit B) 5. If applicable, a floor plan and exit plan (See Exhibit C) 6. Method used to secure tent to the ground. 7. Tent must be 10 from the lot line and no closer than 10 from any other structure on the lot. 8. Wind ratings. 9. The tent may cover no more than 75% of the lot. 10. Provide portable fire extinguishers to be mounted on mast or stay poles, visible for use, for each 2,500 square feet of floor space. 11. No more than four (4) tent permits shall be permitted within a twelve (12) month period, and a period of at least seven (7) days shall be required between each permit period. 12. Fees and Charges: The total amount for the permit is $77; this does not include temporary electric.

4 13. If there will be temporary electric service to the tent, a fee of $100 will be charged for each service. The electrical subcontractor must be licensed and bonded with the City of Naperville, and must sign the Electrical Certification Form included with the application. 14. Tents may be erected for a period not exceeding thirty (30) days for religious, educational or recreational purposes and for a period not exceeding fourteen days (14) for sales or commercial purposes. 15. When the tent is set up, please call the Development Services Team at (630) option 1 to schedule an inspection. The City requires at least 72-hours notice for inspections. Hours to call for inspections are 8:00 a.m. to 4:00 p.m., (closed daily from 1-2 p.m.) Monday through Friday. Any open flames on cooking shall be no closer than 20 feet from a tent or canopy.

5 EXHIBIT A

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8 CITY OF NAPERVILLE DISCLOSURE OF BENEFICIARIES In compliance with Ordinance , An Ordinance amending Title 1 (Administrative) of the Naperville Municipal Code, as amended, by adding Chapter 12 thereto requiring disclosure of certain interests by persons applying for permits, licenses, approvals or benefits from the City of Naperville 1. Applicant: Name Address 2. Nature of Benefit sought: 3. Nature of Applicant: (Please check one) a. Natural Person d. Trust/Trustee b. Corporation e. Partnership c. Land Trust/Trustee f. Joint Venture 4. If applicant is an entity other than described in Section 3, briefly state the nature and characteristics of applicant: 5. If in your answer to Section 3 you checked box b, c, d, e or f, identify by name and address each person or entity which is a 5% shareholder in the case of a corporation, a beneficiary in the case of a trust or land trust, a joint venture in the case of case of a joint venture, or who otherwise has a proprietary interest, interest in profits and losses or right to control such entity: Name Address Interest a. b. c. d. 6. Name, address and capacity of person making this disclosure on behalf of the applicant: IMPORTANT NOTE: In the event your answer to Section 5 identifies entities other than a natural person, additional disclosures are required for each entity. VERIFICATION I,, being first duly sworn under oath, depose and state that I am the person making this disclosure on behalf of the applicant, that I am duly authorized to make this disclosure, that I have read the above and foregoing Disclosure of Beneficiaries, and that the statements contained therein are true in both substance and fact. Subscribed and Sworn to before me this day of, 20. H:\DATA\MADURA\DOCUMENT\DISCL.DOC Rev. 5/22/02 Notary Public